What are patients with early rheumatoid arthritis like in Spain? Description of the PROAR cohort
¿Comó son los pacientes con artritis reumatoide de reciente comienzo en España? descripción de la cohorte PROAR?
Virginia Villaverde Garcíaa, Alejandro Balsab,
, Loreto Carmonac, Raimon Sanmartíd, Jesús Maesec, Dora Pascuale, José Ivorraf, Proar Group
Corresponding author
a Unidad de Reumatología, Hospital de Móstoles, Móstoles, Madrid, Spain
b Servicio de Reumatología, Hospital La Paz, Madrid, Spain
c Unidad de Investigación, Fundación Española de Reumatología, Madrid, Spain
d Servicio de Reumatología, Hospital Clínic, Barcelona, Spain
e Servicio de Inmunología, Hospital La Paz, Madrid, Spain
f Servicio de Reumatología, Hospital Dr. Peset, Valencia, Spain
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Sociodemographic, clinical features, and RA risk factors were recorded. Rheumatoid factor (RF), anti-CCP determinations, and radiographs of hands and feet were analyzed too. After 3 years, a diagnosis of certainty and the variables that determined the evolution to RA, were evaluated.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">One hundred and seventy one patients were included; 161 (94.2%) fulfilled RA diagnostic criteria; most of them (157; 97.5%) in the first visit. Factors associated with RA diagnosis were: positive RF, anti-CCP, and DAS-28; 65% of the patients had radiological erosions in the first visit.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Positive RF, anti-CCP, and the disease activity are predictive factors of RA. Radiological damage exists very early in most of patients, that's why it is more important to treat the disease aggressively instead than achieving an RA diagnosis of certainty</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Identificación de factores presentes en la artritis de reciente comienzo que puedan ayudar a predecir el desarrollo o no de artritis reumatoide (AR). Descripción de las características clínicas de una cohorte de AR de inicio.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cohorte de inicio prospectiva de 5 años de duración en 34 servicios de reumatología españoles formada por pacientes con oligoartritis y poliartritis de menos de un año de evolución no tratados previamente. A todos los pacientes se les realizó al inicio una valoración de la actividad inflamatoria, capacidad funcional y factores de riesgo de AR. Además se realizaron radiografías de manos y pies y determinaciones de factor reumatoide (FR) y de anticuerpos anti-CCP. Tras 3 años, se evaluó el diagnóstico definitivo y las variables que determinaron la evolución hacia AR.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyó a 171 pacientes, de los que 161 (94,2%) acabaron cumpliendo criterios diagnósticos de AR, la mayoría (157; 97,5%) en la visita inicial. Los factores relacionados con el diagnóstico de AR fueron: el FR positivo (odds ratio [OR]<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8,5; intervalo de confianza [IC] del 95%, 1–69,8), los anti-CCP (OR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8,5; IC del 95%, 0,96–75,7) y el DAS28 (OR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1,9; IC del 95%, 1,1–3,3). El 65% de los pacientes presentaban erosiones en la visita basal.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Tanto la extensión de la afección articular como tener un FR positivo y anticuerpos anti-CCP permiten predecir la evolución a AR. El daño radiológico, en muchos pacientes, ya está al inicio, por lo que es más importante un tratamiento contundente precoz que esperar a tener un diagnóstico de AR.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Artritis reumatoide. Epidemiología, etiopatogenia y manifestaciones clínicas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Laffon Roca" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:5 [ "edicion" => "4th ed" "titulo" => "Manual SER de las Enfermedades Reumáticas" "fecha" => "2004" "editorial" => "Panamericana" "editorialLocalizacion" => "Madrid" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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| 2016 December | 43 | 15 | 58 |
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| 2015 August | 1 | 0 | 1 |
| 2015 July | 11 | 3 | 14 |
| 2015 June | 16 | 12 | 28 |
| 2015 May | 35 | 18 | 53 |
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| 2014 December | 24 | 8 | 32 |
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| 2014 October | 20 | 11 | 31 |
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| 2014 August | 23 | 10 | 33 |
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| 2014 June | 29 | 16 | 45 |
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| 2014 April | 23 | 9 | 32 |
| 2014 March | 34 | 18 | 52 |
| 2014 February | 21 | 20 | 41 |
| 2014 January | 24 | 8 | 32 |
| 2013 December | 25 | 14 | 39 |
| 2013 November | 16 | 11 | 27 |
| 2013 October | 37 | 17 | 54 |
| 2013 September | 28 | 10 | 38 |
| 2013 August | 26 | 5 | 31 |
| 2013 July | 24 | 8 | 32 |
| 2013 June | 23 | 10 | 33 |
| 2013 May | 21 | 13 | 34 |
| 2013 April | 20 | 13 | 33 |
| 2013 March | 32 | 12 | 44 |
| 2013 February | 19 | 8 | 27 |
| 2013 January | 14 | 6 | 20 |
| 2012 December | 20 | 7 | 27 |
| 2012 November | 6 | 2 | 8 |
| 2012 October | 2 | 2 | 4 |
| 2012 September | 4 | 3 | 7 |
| 2012 May | 1 | 0 | 1 |
| 2012 April | 3 | 0 | 3 |
| 2012 March | 1 | 0 | 1 |
| 2012 February | 4 | 0 | 4 |
| 2012 January | 6 | 0 | 6 |
| 2011 December | 5 | 0 | 5 |
| 2011 November | 4 | 0 | 4 |
| 2011 October | 2 | 0 | 2 |
| 2011 September | 2 | 0 | 2 |
| 2011 August | 1 | 0 | 1 |
| 2011 June | 5 | 0 | 5 |
| 2011 May | 2 | 0 | 2 |
| 2011 March | 4 | 0 | 4 |
| 2011 February | 4 | 0 | 4 |
| 2011 January | 4 | 0 | 4 |
| 2010 December | 6 | 0 | 6 |
| 2010 November | 6 | 0 | 6 |
| 2010 October | 2 | 0 | 2 |
| 2010 September | 13 | 0 | 13 |
| 2010 August | 4 | 0 | 4 |
| 2010 July | 4 | 0 | 4 |
| 2010 June | 1 | 0 | 1 |
| 2010 May | 3 | 0 | 3 |
| 2010 April | 3 | 0 | 3 |
| 2010 March | 6 | 0 | 6 |
| 2010 February | 1 | 0 | 1 |
| 2010 January | 4 | 0 | 4 |
| 2009 December | 7 | 0 | 7 |
| 2009 November | 17 | 0 | 17 |
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